Ask Dr. Z

Four years ago you were asked this question: If we are doing a procedure and cause a dissection that needs to be treated with a stent, can stent device and/or pro fee for placement be charged? Is there a CMS or ACR directive on billing an iatrogenic procedure caused during a procedure? Answer: Currently we would code for the dissection treatment. If you don’t fix it, you may need to send to surgery to fix. This type of iatrogenic injury is uncommon but does occur. The first time we have seen guidance to not charge for this type of issue is with code 61650 (for intracranial vasospasm infusion) where, in the code description, it states NOT to use for iatrogenically-induced vasospasm treatment. I have not seen any further guidance on other procedures like the one you mention here being limited….yet. -Dr. Z

Asking the question again in 2020, has your opinion changed or stayed the same? Has there been any CMS or other guidance on this since 2016?